Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website. See our User Agreement and Privacy Policy.

Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. If you continue browsing the site, you agree to the use of cookies on this website. See our Privacy Policy and User Agreement for details.

12.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Anatomy of the Skin
Facts about the skin:
The skin is the body''s largest organ, covering the entire body. In addition to serving
as a protective shield against heat, light, injury, and infection, the skin also:
 regulates body temperature.
 stores water and fat.
 is a sensory organ.
 prevents water loss.
 prevents entry of bacteria.
Throughout the body, the skin''s characteristics (thickness, color, texture) vary. For
instance, the head contains more hair follicles than anywhere else, while the soles of
the feet contain none. In addition, the soles of the feet and the palms of the hands are
much thicker. The skin is made up of the following layers, with each layer performing
specific functions:
 epidermis
 dermis
 subcutaneous fat layer
12 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

13.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
epidermis The epidermis is the thin outer layer of the skin and
consists of three parts:
 stratum corneum (horny layer)
This layer consists of fully mature
keratinocytes which contain fibrous proteins
(keratins). The outermost layer is continuously
shed. The stratum corneum prevents the entry
of most foreign substances as well as the loss
of fluid from the body.
 keratinocytes (squamous cells)
This layer, just beneath the stratum corneum,
contains living keratinocytes (squamous cells),
which mature and form the stratum corneum.
 basal layer
The basal layer is the deepest layer of the
epidermis, containing basal cells. Basal cells
continually divide, forming new keratinocytes
that replace the cells that are shed from the
skin''s surface.
The epidermis also contains melanocytes, which are
cells that produce melanin (skin pigment).
dermis The dermis is the middle layer of the skin. The
dermis contains the following:
 blood vessels  collagen bundles
 lymph vessels  fibroblasts
 hair follicles  nerves
 sweat glands
The dermis is held together by a protein called
collagen, made by fibroblasts. This layer also
contains pain and touch receptors.
subcutis The subcutis is the deepest layer of skin. The
subcutis, consisting of a network of collagen and fat
cells, helps conserve the body''s heat and protects
the body from injury by acting as a shock absorber.
13 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

14.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Describing a Skin Condition
How to describe a skin condition:
A physician may ask you to describe your dermatological condition and its location.
Here are some of the more common terms that may help you in providing a more
accurate description:
atrophic thin, wrinkled
blister fluid-filled bump
formation of dried blood, pus, or other skin fluid
crust/scab
over a break in the skin
cyst deeply seated lesion that contains material
excoriation a scratch
hives/wheals pink or white swelling of the skin
lichenification skin that has thickened
macule a flat discolored spot
nodule/papule solid, raised bump
raised bumps bumps that stick out above the skin surface
patch flat, discolored spot
pustule
inflamed lesions that appear to contain pus
(pimple)
scales dead skin cells that form flakes
scar fibrous tissue that forms after a skin injury
14 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

15.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Descriptive terms
Macule
the term macule is used to describe changes in colour or consistency ►
without any elevation above the surface of the surrounding skin.
There may be an increase of melanin, giving a black or blue colour ►
depending on the depth of the pigment. Loss of melanin leads to a white
macule. Vascular dilatation and inflammation produce erythema.
Papules and nodules
A papule is a circumscribed, raised lesion, conventionally less than 1 cm in ►
0diameter. It may be due to either epidermal or dermal changes
A nodule is similar to a papule but over 1 cm in diameter.
A vascular papule or nodule is known as an haemangioma
Plaque
Plaque is one of those terms which conveys a clear meaning to ►
dermatologists .
Plaques are most commonly seen in psoriasis.
15 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

16.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Vesicles and bullae
Vesicles and bullae are raised lesions that contain fluid.
A bulla is a vesicle larger than 0.5 cm. They may be superficial ►
within the epidermis or situated in the dermis below it.
Lichenification
Lichenification is another term frequently used in dermatology . ►
Some resemblance to lichen seen on rocks and trees does occur, ►
with hard thickening of the skin and accentuated skin markings.
It is most often seen as a result of prolonged rubbing of the skin ►
in localized areas of eczema
Nummular
Nummular means a ―coin-like‖ lesion.
There is no hard and fast distinction from discoid lesions, which are flat ►
disc-like lesions of variable size.
16 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

17.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
It is most often used to describe a type of eczematous lesion . ►
pustule
The term pustule is applied to lesions containing purulent material—which ►
which may be due to infection 0R sterile pustules,
are seen in pustular psoriasis.
Atrophy
Atrophy refers to loss of tissue which may affect the epidermis, dermis, or ►
subcutaneous fat.
Thinning of the epidermis is characterised by loss of the normal skin ►
markings, and there may be fine wrinkles, loss of pigment, and a
translucent appearance.
There may be other changes as well, such as sclerosis of the underlying ►
connective tissue, telangiectasia, or evidence of diminished blood supply.
Ulceration
Ulceration results from the loss of the whole thickness of the epidermis and ►
upper dermis.
Healing results in a scar.
17 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

18.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
An erosion
An erosion is a superficial loss of epidermis that generally heals without scarring.
Excoriation
Excoriation is the partial or complete loss of epidermis as a result of scratching
Fissures
Fissures are slits through the whole thickness of the skin.
Desquamation
Desquamation is the peeling of superficial scales, often following acute ►
inflammation.
18 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

20.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
atopic dermatitis (Also called eczema.) - a skin disorder that is characterized by
itching, scaling, thickening of the skin, and is usually located on the face, elbows,
knees, and arms.
atrophic skin - skin that is thin and wrinkled.
basal cell carcinoma - the most common form of skin cancer; characterized by small,
shiny, raised bumps on the skin that may bleed.
basal cells - type of cells that are found in the outer layer of skin. Basal cells are
responsible for producing the squamous cells in the skin.
birthmark - abnormality of the skin that is present at birth or shortly afterward.
bed sores - ulcers that occur on areas of the skin that are under pressure from lying in
bed, sitting in wheelchairs, wearing a cast, or being immobile for a long period of
time.
biopsy - a procedure performed to remove tissue or cells from the body for
examination under a microscope.
blister - a fluid-filled bump.
boil - tender, swollen areas that form around hair follicles.
botulinum toxin type A - an injection of botulinum toxin into specific muscles will
immobilize those muscles, preventing them from forming wrinkles and furrows.
candidiasis (Also called yeast infection.) - a skin infection caused by yeast that can
occur in the skin folds, navel, vagina, penis, mouth, and nail beds.
carbuncles - clusters of boils on the skin.
cavernous hemangioma - a raised, red or purple mark in the skin, made up of
enlarged blood vessels.
cellulitis - a bacterial infection of the skin that is characterized by swelling and
tenderness.
chemical peels - a procedure often used to minimize sun-damaged skin, irregular
pigment, and superficial scars. The top layer of skin is removed with a chemical
application to the skin. By removing the top layer, the skin regenerates, often
improving the skin''s appearance.
20 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

21.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
cold sore - small blisters around and in the mouth caused by the herpes simplex virus.
collagen - a natural protein found in humans that forms connective tissue and provides
strength, resilience, and support to the skin, ligaments, tendons, bones, and other parts
of the body.
collagen injections - one type of collagen, which is derived from purified bovine
(cow) collagen, is injected beneath the skin to replace the body''s natural collagen that
has been lost. Injectable collagen is generally used to treat wrinkles, scars, and facial
lines.
creeping eruption - a skin infection caused by hookworms that is characterized by
severe itching.
crust (Also called scab.) - a formation of dried blood, pus, or other skin fluid over a
break in the skin.
cryosurgery - destruction of a lesion on the skin by freezing with liquid nitrogen.
cyst - a deep lesion that is filled with pus or other contents.
dermabrasion - used to minimize small scars, minor skin surface irregularities,
surgical scars, and acne scars. As the name implies, dermabrasion involves removing
the top layers of skin with an electrical machine that "abrades" the skin. As the skin
heals from the procedure, the surface appears smoother and fresher.
dermatitis - a number of skin conditions characterized by inflammation of the skin.
dermatofibroma - small, red or brown bumps in the skin.
dermis - the middle layer of skin, which is made up of blood vessels, lymph vessels,
hair follicles, sweat glands, collagen bundles, and fibroblasts.
dermoid cyst - a benign tumor made up of hairs, sweat glands, and sebaceous glands.
eczema (Also called atopic dermatitis.) - a skin disorder that is characterized by
itching, scaling, thickening of the skin, and is usually located on the face, elbows,
knees, and arms.
epidermis - the outermost layer of skin.
erysipelas - a bacterial skin infection that usually affects the arms, legs, or face,
characterized by shiny, red areas, small blisters, and swollen lymph nodes.
21 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

22.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
erythema multiforme - a skin condition characterized by symmetrical, red, raised
skin areas all over the body.
erythema nodosum - a skin condition characterized by red bumps that usually appear
on the shins.
erythrasma - a skin infection of the top layer of skin characterized by irregular pink
patches that turn to brown scales.
exanthem - a rash.
excoriation - an area of the skin covered by a crust, or scab, usually caused by
scratching.
folliculitis - an inflammation of the hair follicles due to an infection or irritation.
freckles - darkened, flat spots that typically appear only on sun-exposed areas of skin.
granuloma annulare - a chronic skin condition characterized by small, raised bumps
that form a ring with a normal or sunken center.
herpes zoster (Also called shingles.) - a common viral infection of the nerves,
characterized by a painful skin rash of small blisters anywhere on the body.
hirsutism - excessive hairiness.
hives (Also called urticaria.) - a condition in which red, itchy, and swollen areas
appear on the skin - usually as an allergic reaction from eating certain foods or taking
certain medications.
immune system - a collection of cells and proteins that works to protect the body
from potentially harmful, infectious microorganisms, such as bacteria, viruses, and
fungi.
immunocompromised - an abnormal condition in which one''s ability to fight
infection is decreased. This can be due to a disease process, certain medications, or a
condition present at birth.
impetigo - a bacterial skin infection characterized by microscopic, pus-filled blisters.
inflammation - redness, swelling, heat, and pain in a tissue due to chemical
or physical injury, infection, or allergic reaction.
22 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

23.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
keloids - smooth, pink, raised, firm, fibrous growths on the skin that form secondary
to injury.
keratinocytes (Also called squamous cells.) - the primary cell types found in the
epidermis, the outer layer of skin.
keratoacanthomas - round, flesh-colored growths with craters that contain a pasty
material.
keratosis pilaris - a common skin condition characterized by small, pointed bumps,
especially on the back and sides of the upper arms.
laser resurfacing - uses high-energy light to burn away damaged skin. Laser
resurfacing may be used to minimize wrinkles and fine scars.
lice - tiny parasites that can infest the skin; characterized by intense itching.
lichenification - skin that has thickened.
lipomas - round or oval lumps under the skin caused by fatty deposits.
lymphangioma - a raised, yellow-tan or red mark in the skin, made up of enlarged
lymphatic vessels.
macular stains (Also called angel''s kisses or stork bites.) - faint, red marks that
appear in the skin at birth. Angel''s kisses are marks on the forehead and eyelids. Stork
bites are marks on the back of the neck.
macule - the smaller version of a patch - a flat discolored spot.
malignant melanoma - a rare, but sometimes deadly, skin cancer that begins as a
mole that turns cancerous.
melanocytes - cells present in the epidermis that produce melanin (skin pigment).
melasma - dark, brown symmetrical patches of pigment on the face.
moles - small skin marks caused by pigment-producing cells in the skin.
Mongolian spots - Bluish-black marks on the lower back and buttocks; affects mainly
African-American or Asian children.
nodule (Also called papule.) - a solid, raised bump.
23 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

24.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
paronychia - a skin infection around a finger or toenail.
patch - a flat, discolored spot.
pityriasis rosea - a common skin condition characterized by scaly, pink, and inflamed
skin.
port-wine stains (Also called nevi flammeus.) - permanent flat, pink, red, or purple
marks on the skin.
prickly heat - a rash caused by trapped sweat under the skin.
psoriasis - a chronic skin condition characterized by inflamed, red, raised areas that
develop silvery scales.
punch grafts - small skin grafts to replace scarred skin. A hole is punched in the skin
to remove the scar, which is then replaced with unscarred skin (often from the back of
the earlobe). Punch grafts can help treat deep acne scars.
pustule (Also called pimple.) - inflamed lesions that look like pink bumps.
pyogenic granuloma - red, brown, or bluish-black raised marks caused by excessive
growth of capillaries.
ringworm - a fungal skin infection characterized by ring-shaped, red, scaly, or
blistery patches.
rosacea - a common skin condition characterized by redness, pimples, and broken
blood vessels.
salicylic acid - a keratolytic drug (a drug that removes the outer layer of skin) that is
used to treat various skin conditions.
sarcoidosis - an inflammation of the lymph nodes and other organs.
scabies - an infestation of mites in the skin characterized by small pimples that itch.
scales - dead skin cells that look like flakes or dry skin.
scar - fibrous tissue that has formed after a skin injury.
sebaceous glands - glands in the skin that secrete oil to the surface of the skin.
24 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

25.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
seborrheic keratosis - flesh-colored, yellow, brown, or black wart-like spots.
skin tags - soft, small, flesh-colored skin flaps on the neck, armpits, or groin.
spider angioma - a bright red mark with a distinct dark spot in the skin.
squamous cells (Also called keratinocytes.) - the primary cell types found in the
epidermis, the outer layer of skin.
squamous cell carcinoma - a form of skin cancer that affects about 20 percent of
patients with skin cancer. This highly treatable cancer is characterized by red, scaly
skin that becomes an open sore.
subcutis - the deepest layer of skin; also known as the subcutaneous layer.
tinea versicolor - a common fungal skin infection characterized by white or light
brown patches on the skin.
toxic epidermal necrolysis - a life-threatening skin disorder characterized by
blistering and peeling of the top layer of skin.
tretinoin - a drug which is chemically related to vitamin A; used to treat acne and
other scaly skin disorders.
trichotillomania - hair pulling.
urticaria (Also called hives.) - a condition in which red, itchy, and swollen areas
appear on the skin - usually as an allergic reaction from eating certain foods or taking
certain medications.
urushiol - resin in poison ivy plants that causes an allergic skin reaction.
vitiligo - smooth, white patches in the skin caused by the loss of pigment-producing
cells.
wart - a non-cancerous skin growth caused by a virus.
25 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

26.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Diagnosis of rash
• Previous episodes of the rash, particularly in childhood, suggest a ►
constitutional condition such as atopic eczema
• Recurrences of the rash, particularly in specif situations, suggests a ►
contact dermatitis.
Similarly a rash that only occurs in the summer months may well have a ►
photosensitive basis.
• If other members of the family are affected, particularly without any ►
previous history, there may well be a transmissible condition such as
scabies
A simplistic approach to rashes is to clarify them as being from ―inside‖ or ►
―outside‖
Examples of ―inside‖ or endogenous rashes are atopic eczema or drug rashes,
whereas fungal infection or contact dermatitis are ―outside‖ rashes.
History
A relevant history should be taken in relation to
occupational and environmental factors
• Where? Site of initial lesion(s) and subsequent distribution
• How long? Has condition been continuous or intermittent?
• Prognosis—Is it getting better or worse?
• Previous episodes—How long ago? Were they similar? Have
there been other skin conditions?
• Who else? Are other members of the family affected? Or
colleagues at work or school?
• Other features—Is there itching, burning, scaling, or blisters?
Any association with drugs or other illnesses?
• Treatment—By prescription or over the counter? Have
prescribed treatments actually been used?
Examinination
The following points are helpful when examining
skin lesions
Distribution
• This may give the essential clue, so a full examination is
necessary. For example, there are many possible causes for
26 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

27.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
dry thickened skin on the palms, and finding typical psoriasis
on the elbows, knees, and soles may give the diagnosis
Morphology
• Are the lesions dermal or epidermal? Macular (flat) or
forming papules? Indurated or forming plaques? With a well
defined edge? Forming crusts, scabs, or vesicles?
Pattern
• This is the overall clinical picture of both morphology and
distribution. For example, an indeterminate rash may be
revealed as pityriasis rosea when the ―herald patch‖ is found
Skin Tests
What are skin tests?
Skin tests may be performed to diagnose skin allergies, bacterial or fungal skin
infections, and other diseases. Skin tests are also performed to differentiate between
malignant (cancerous) cells and benign (noncancerous) growths.
What are the most common skin tests?
 patch testing
Patch tests are used to help diagnose skin allergies. Identified allergins are
applied to the skin with adhesive patches and left for a period of time. The skin
is then examined for any reaction.
 skin biopsy
A skin biopsy is the removal of skin for laboratory analysis. The sample of skin
may be removed with a scalpel or a cylindrical punch, after local anesthesia.
Skin biopsies are performed to diagnose skin cancer or benign skin disorders.
 culture
Skin, hair, or nails may be cultured to detect bacteria, fungi, or viruses.
27 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

28.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Common Dermatological Procedures
The skin, the largest organ of the body, helps define a person''s look. Any unsightly
skin appearance, such as scarring, can affect both mental and physical well-being. In
addition, because the skin is on the outside of the body, it is more susceptible to
growths, discolorations, and disease.
There are many different dermatological procedures designed to improve the condition
or appearance of the skin. Listed in the directory below are some, for which we have
provided a brief overview.
 Acne Scar Removal
 Chemical Peel
 Dermabrasion / Dermaplaning
 Laser Surgery Overview
 Laser Surgery for Skin Conditions
28 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

30.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
o Baldness (Alopecia)
o Excessive Hairiness (Hirsutism)
There are a great deal of common skin diseases, ranging from the very mild to
the severe, so it's important to learn about all of them. Being able to recognize a
dermatological disorder is the first step towards figuring out the best way to treat
the condition.
We will cover various afflictions and diseases of the skin in this article, some
more prevalent than others. The most important thing to remember is if you
notice any strange markings, itching, burning or anything out of the ordinary on
any part of your body, make sure you visit your dermatologist as soon as
possible.
Allergic dermatitis is one of the most common skin diseases, marked by an
allergic reaction that usually appears within 48 hours of being exposed to the
irritant. Redness, swelling and itching are symptoms, and the condition most
often affects adults. Poison ivy and oak are major culprits.
No list of skin disease would be complete without herpes simplex, commonly
known as cold sores. This is a viral infection that is spread by close or sexual
contact. Various drugs and treatments can keep it under control, but it never
quite leaves your system.
One of the common skin diseases related to allergic dermatitis is eczema, a
stubborn rash occurring in millions of people with sensitive skin. Although there
is no cure, it can be kept under control with cortisone and other medications.
Hyperhidrosis, or excessive sweating, is another of the common diseases of the
skin which usually occurs following puberty. It is noticeable in the armpits as
well as the soles of the feet and palms, and can be controlled with an strong anti-
perspirant.
Ring worm is a fungal infection of the skin, called tinea corporis. It forms a lesion
with a rough, circular border but can be eliminated with proper treatment.
Usually an anti-fungal medication can do the trick.
Some of the prevalent diseases of the skin are not true diseases, but rather
conditions that may or not be treatable. Those are skin tags, warts, sun spots,
moles, pimples and rashes.
Many of these dermatological ailments are treatable with the right medication,
and the earlier you address the situation the more likely you are to get the skin
disease under control.
30 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

32.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
5. Local treatment and light therapy, used simultaneously with systemic
treatment
6. Incision and drainage of pus-containing cysts with a large-caliber injection
needle or narrow-tipped scalpel
7. Hormonal treatment for women: cyproterone acetate (an anti-androgen) +
oestrogen
8. Treatment of scars by skin abrasion or laser therapy (by a dermatologist or
a plastic surgeon)
9. Isotretinoin upon recommendation of a dermatologist
Treatment
Local Treatment
 Local treatment is usually sufficient for comedonic acne and mild common
acne.
 Wash the skin with soap or antibacterial detergents.
 Comedonic acne can be treated with
 Retinoic acid cream or solution (tretinoin [Purdy, 2005] [A],
isotretinoin[ [Purdy, 2005] [B])
 Adapalen gel (Purdy, 2005) [C]
 Benzoyl peroxide (3 to 10%)] (Purdy, 2005) [A] cream or gel
 All above drugs can be irritating at first. Use a low concentration of
the active drug initially, and advise the patient to wash the drug
away after a few hours. The tolerance of the skin increases with time.
 Common acne can be treated with
 Local antibiotics (e.g., clindamycin solution) (Purdy, 2005) [A]
 Combination gel containing benzoyl peroxide and clindamycin
 Ultraviolet light therapy (as a course of 15 treatments added to other
treatment) for widespread disease
 Consider systemic treatment if the effect of local treatment is
unsatisfactory 2 to 3 months from the onset of treatment.
Systemic Treatment
 Antibiotics
 Tetracycline (Garner et al., 2003) [B] and erythromycin (Purdy,
2005) [A] are equally effective. The usual dose is 250 to 500 mg/day
for a few months. Six months' treatment with tetracycline or
erythromycin 1 g/day is more effective than a shorter treatment with
a smaller dose. Do not use tetracyclines in children below 12 years of
age.
32 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

33.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Local treatment and light therapy can be used simultaneously with
systemic treatment.
 Local treatment is not sufficient in cystic acne and conglobate acne.
Use systemic antibiotics or consider referral to a dermatologist. Pus-
containing cysts can be drained by incising them with a large-caliber
injection needle or narrow-tipped scalpel.
 Hormonal treatment for women
 Cyproterone acetate (an anti-androgen) + oestrogen for 6 months
reduce the excretion of sebaceous glands and alleviate acne.
Acne Scars
 Consider treatment of scars by skin abrasion or laser therapy (Jordan,
Cummins, & Burls, 1998; Health Technology Assessment Database [HTA]-
998502, 2001) [D] only after the activity of the disease has totally subsided.
 Scars can be treated either by a dermatologist or a plastic surgeon.
Indications for Specialist Consultation
 Severe forms of acne (a. cystica, conglobata, fulminans)
 If ordinary treatment fails, the dermatologist can consider isotretinoin.
However, it has considerable teratogenicity. A program called iPLEDGE
has been set up to make sure that pregnant women do not take isotretinoin
and that women do not become pregnant while taking isotretinoin:
Related Resources
Cochrane Reviews
 There is not enough data to evaluate the effectiveness of spironolactone as
treatment of acne (Farquhar et al., 2003) [C].
Other Evidence Summaries
 Azelaic acid may be effective in reducing inflammatory lesions and
comedones in patients with acne vulgaris (Purdy, 2005) [C].
 Topical erythromycin appears to be effective in reducing inflammatory
lesions in patients with acne vulgaris (Purdy, 2005) [A].
 Topical tetracycline appears to be effective in reducing acne severity, but it
causes skin discolouration (Purdy, 2005) [B].
 Oral doxycycline is as effective as oral minocycline and oral erythromycin
in reducing lesions in patients with acne vulgaris (Purdy, 2005) [A].
33 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

34.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Retinoic acid cream or solution, adapalen gel, and benzoyl peroxide (3 to
10%) can be irritating at first. The tolerance of the skin increases with time.
 Isotretinoin has considerable teratogenicity
CONTRAINDICATIONS
Tetracyclines should not be used in children below 12 years of age.
Isotretinoin is contraindicated in pregnancy.
RECOMMENDATION
1. Acne is common and distressing to patients but can almost always be well
controlled.
2. The pathogenesis of acne starts with androgenic stimulation of the
pilosebaceous unit causing increased sebum and hyperkeratinization that
leads to follicular plugging and a comedone. Propionibacterium acnes then
proliferates within the comedone and releases inflammatory mediators and
chemoattractants.
3. Topical retinoids are an excellent cornerstone for all facets of acne therapy.
4. Patients should be reassessed after a minimum of 6 to 8 weeks to give the
medications adequate time to work.
Acne Vulgaris, Acne Juvenilis
Acne Infantilis, Infantile Acne
Acne Cystica
34 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

36.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Bed Sores
What are bed sores?
Bed sores can occur when a person is bedridden, unconscious, unable to sense
pain, or immobile. Bed sores are ulcers that occur on areas of the skin that are
under pressure from lying in bed, sitting in a wheelchair, and/or wearing a cast
for a prolonged period of time.
Why does a bed sore develop?
A bed sore develops when blood supply to the skin is cut off for more than two to
three hours. As the skin dies, the bed sore first starts as a red, painful area, which
eventually turns purple. Left untreated, the skin can break open and become
infected. A bed sore can become deep, extending into the muscle. Once a bed sore
develops, it is often very slow to heal. Bed sores often occur in the buttocks area
(on the sacrum or iliac crest), or on the heels of the feet.
Preventing bed sores:
Bed sores can be prevented by inspecting the skin for areas of redness (the first
sign of skin breakdown). Other methods of preventing bed sores and preventing
progression of existing bed sores include the following:
 frequent turning and repositioning
 providing soft padding in wheelchairs and beds to reduce pressure
 providing good skin care by keeping the skin clean and dry
Treatment for bed sores:
Specific treatment of a bed sore is determined by your physician and based on
the severity of the condition. Treatment may be more difficult once the skin is
broken, and may include the following:
 removing pressure on the affected area
36 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

37.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
 protecting the wound with medicated gauze or other special dressings
 keeping the wound clean
 transplanting healthy skin to the wound area
 medication (i.e., antibiotics to treat infections)
Calluses and Corns
What are calluses and corns?
Calluses are protective pads made up of the thickened upper layer of skin due to
repeated rubbing of the area. Corns are small calluses that develop on the top of
the toes due to pressure or rubbing against shoes or other toes.
Treatment for calluses and corns:
Calluses are usually painless, but corns can be quite painful. Sometimes, corns
are confused with warts. Calluses can be avoided by removing the source of the
rubbing and thinning the callus with a pumice stone. Treatment for corns may
include:
 applying pads around the corn area
 wearing larger, more comfortable shoes
 surgery
Dry Skin
What is dry skin?
Dry skin is a very common skin condition, usually characterized by irritated skin
and itchiness. Dry skin often worsens in the winter, when the air is cold and dry.
In addition, frequent bathing can aggravate dry skin. Dry skin may become flaky
or scaly.
However, dry skin symptoms may resemble other skin conditions or result from
other disorders such as an underactive thyroid or acquired immune deficiency
syndrome (AIDS). Always consult your physician for a diagnosis.
Treatment for dry skin:
37 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

38.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Treating dry skin may be as simple as keeping the skin moist - by taking fewer
baths and using ointments or creams that keep the moisture in. Treatment may
also include:
 avoiding harsh soaps, detergents, and perfumes, which tend to dry the skin
 avoiding rubbing or scratching the skin, which can aggravate the
symptoms and cause infection
 applying a salicylic acid solution or cream (which removes the top layer of
skin) - if the skin is scaly
Keratosis Pilaris
What is keratosis pilaris?
Keratosis pilaris is a common skin disorder characterized by small, pointed
pimples. The pimples usually appear on the upper arms, thighs, and buttocks.
The condition worsens in the winter and usually clears up in the summer.
Keratosis pilaris has no known cause, but tends to run in families.
Treatment for keratosis pilaris:
Usually no treatment is necessary for keratosis pilaris, since it normally clears up
by itself. Treatment may include:
 using petroleum jelly with water, cold cream, or salicylic acid (which
removes the top layer of skin) to flatten the pimples
 using a tretinoin cream (a drug which is chemically related to vitamin A)
38 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

39.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Pityriasis Rosea
What is pityriasis rosea?
Pityriasis rosea is a mild, but common, skin condition. Characterized by scaly,
pink, inflamed skin, the condition can last from four to eight weeks and usually
leaves no lasting marks.
What causes pityriasis rosea?
The cause of pityriasis rosea is not known, but it is commonly believed to be
caused by a virus. It is usually seen in children, adolescents, and young adults.
More than 75 percent of people with the rash are 10 to 35 years of age.
The condition is more prevalent in spring and fall.
What are the symptoms of pityriasis rosea?
Pityriasis rosea usually starts with a pink or tan oval area (sometimes called a
herald or mother patch) on the chest or back. The main patch is usually followed
(after a couple of weeks) by smaller pink or tan patches elsewhere on the body -
usually the back, neck, arms, and legs. The scaly rash usually lasts between four
to eight weeks and will disappear without treatment.
The following are other common symptoms of pityriasis rosea. However, each
individual may experience symptoms differently. Symptoms may include:
 headaches
 fatigue
 aches
 itching
The symptoms of pityriasis rosea may resemble other skin conditions. Always
consult your physician for a diagnosis.
39 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

40.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
How is pityriasis rosea diagnosed?
Pityriasis rosea is usually diagnosed based on a medical history and physical
examination. The rash of pityriasis rosea is unique, and the diagnosis is usually
made on the basis of a physical examination. In addition, your physician may
order the following tests to help aid in the diagnosis:
 blood tests
 skin biopsy - the removal of some of the diseased skin for laboratory
analysis. The sample of skin is removed after a local anesthetic is
administered.
Treatment for pityriasis rosea:
Specific treatment for pityriasis rosea will be determined based on:
 overall health, and medical history
 extent of the rash
 tolerance for specific medications, procedures, or therapies
 expectations for the course of the rash
 opinion or preference
The goal of treatment for pityriasis rosea is to relieve symptoms associated with
the condition, such as itching. There is no cure for pityriasis rosea. The condition
will resolve spontaneously. Treatment may include:
 medicated lotions and creams (to soothe the itching)
 medications by mouth (to soothe the itching)
 cool baths with or without oatmeal (to soothe the itching)
 ultraviolet exposure (under a physician''s supervision)
 cool compresses (to soothe the affected skin)
40 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

41.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Psoriasis
What is psoriasis?
Psoriasis is a chronic skin condition characterized by inflamed, red, raised
areas that often develop as silvery scales on the scalp, elbows, knees, and
lower back. Psoriasis affects nearly 6 million people in the US.
What causes psoriasis?
The cause of psoriasis is unknown, however, it is thought to be caused by
abnormally fast-growing and shedding skin cells. The skin cells multiply so
quickly, causing the skin to shed every three to four days. Though not
contagious, the condition is hereditary. Psoriasis is often recurrent and occurs
in varying severities.
What are the symptoms of psoriasis?
The following are the most common symptoms of psoriasis. However, each
individual may experience symptoms differently, as psoriasis comes in several
forms and severities. Symptoms may include:
 discoid psoriasis
Also called plaque psoriasis, this type of psoriasis is the most common.
Symptoms may include patches of red, raised skin on the trunk, arms,
41 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

42.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
legs, knees, elbows, genitals, and scalp. Nails may also thicken, become
pitted, and separate from the nail beds.
Plaques in psoriasis
 guttate psoriasis
This type of psoriasis affects mostly children. Symptoms may include
many small patches of red, raised skin. A sore throat usually proceeds
the onset of this type of psoriasis.
Guttate psoriasis
 pustular psoriasis
Symptoms may include small pustules (pus-containing blisters) all over
the body or just on the palms, soles, and other small areas.
Pustules on the foot
42 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

43.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Psoriasis of both legs
Pitting of the nail
Psoriasis Arthropathica
definition
Syndrome in which psoriasis is associated with arthritis, often involving
inflammation in terminal interphalangeal joints. A rheumatoid factor is not
usually present in the sera of affected individuals.
Acute arthropathy
Psoriasis of the scalp
This condition can be very difficult to clear, particularly if there are thick
scales
• 3% salicylic acid in a suitable base and left on for four to six hours or
overnight and then washed out with a tar shampoo
• Dithranol preparations are effective but will tint blonde or red hair purple
• Steroid preparations can be used to control itching
43 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

44.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Erythrodermic psoriasis
► Erythrodermic psoriasis is a serious, even life threatening, condition with
erythema affecting nearly the whole of the skin.
Diagnosis may not be easy as the characteristic scaling of psoriasis is absent,
although this usually precedes the erythroderma.
Less commonly the erythema develops suddenly without preceding lesions.
There is a considerable increase in cutaneous blood flow, heat loss, metabolism,
and water loss.
How is psoriasis diagnosed?
When the condition progresses to the development of silvery scales, the physician
can usually diagnose psoriasis with a medical examination of the nails and skin.
Confirmation of diagnosis may be done with a skin biopsy (taking a small skin
specimen to examine under a microscope).
44 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429

46.
. ‫اٌٛؽذح األٌٚٝ : .. األِشاع اٌغٍذ٠خ اٌشبئؼخ‬
Rosacea
What is rosacea?
Rosacea is a common skin condition that usually only affects the face and eyes.
Characterized by redness, pimples, and broken blood vessels, rosacea tends to
begin after middle age (between the ages of 30 and 60) and is more common in
fair-skinned people.
The cause of rosacea is unknown. An estimated 14 million people in the US have
rosacea.
Rosacea
Rhinophyma
What are the symptoms of rosacea?
Rosacea often begins with easy blushing and flushing of the facial skin.
Eventually, redness will persist around the nose area, extending to the rest of the
face. Rosacea has a variety of clinical symptoms and is classified into the
following four types, based on these different symptoms:
46 ‫إداسح اٌجشاِظ اٌظؾ١خ ٚاٌزذس٠ت ثبٌشػب٠خ اٌظؾ١خ األٌٚ١خ ثّٕـمخ اٌش٠بع‬ 1429